13 replies to this topic

[Captain Robin Phoenix]

Okay, let's talk about characters, simming, counseling sessions, fun and ecerything else

[Solok]

I've got a question. How closely tied together are the medical and counseling departments? Are they two branches of the same basic department? Or are they two totally distinct departments? Should the Counselor be present at Medical department meetings? Are the Counselor and CMO equals in terms of patient care, or does the CMO have more say in how patients are treated?

[Solok]

We're discussing this from time to time in the Medical forum, but, in the spirit of dialogue: Maybe a part of the answer to my question, above, is answered by thinking of Counselors in terms of psychologists and therapists, and Medical Officers as, in part, psychiatrists.

Thoughts on this?

[FltAdml. Wolf]

An interesting viewpoint. "Psychology" per se, seems to involve understanding how the mind works, though. While therapy (at least in my understanding -- from the monumentous amount I've been involved in ), is more about solving problems. I see psychology as more of an academic endeavour, which sometimes works to try and solve people's problems (behavioral psyc), while therapy is mostly about solving people's problems through changes in behavior. Euh... yeah. I guess.

[Gwen Hilzarie]

On the Conny the departments are not one in the same by any means.

Gwen is a special case in that she started as a medical officer and moved to the councelling position when T'Lara left the base. So that combined with my rank vs the rank of the CMO I could throw my weight around in sickbay. However I don't frequently durring a mission medical will heal the body and I will heal the mind. In rare cases when they are related the medical team and I will work together. However I consider my self and my few assistants (NPC) a seprate department.

[Solok]

Can Counselors (who are not MDs like yourself, Gwen) prescribe drugs? Or is that the sole province of Medical?

I still think the psychiatry/psychology distinction might be the most useful here. Medical officers treat mental disorder as a problem in brain function, and try to correct with drugs that alter the brain chemistry. Counselors treat mental disorder as a problem for behavior, thought or emotion, and try to assist with some version of psychotherapy. In that sense, both the MOs and the Counselors are treating the mind -- the MOs are just treating it as a part of the body.

The Counselor's job (if Troi is any example) also seems to transfer to "tactical diagnosis," whereby the CO is given whatever useful psychological information can be determined about the persons with whom the vessel and crew are interacting. That seems to me to be the sole reason Troi had a seat on the bridge. And in this, the CMO would play no role. That might be the basis for a strong argument that, according to canon, the departments are separate.

Sadly, though, Gwen, the folks in the Medical forum have already decided that Counselors are specialized Medical Officers, and, regardless of rank, are accountable to the CMO. (You might head over there and try to set them straight.)

[Gwen Hilzarie]

Other Ships can so what ever they want but I'm not taking orders from a Lt. jg!

And I think Hebron regards me as altmost part of the command staff and not medical.

[Solok]

That's interesting. Can you explain a little how the Counselor fits into the command staff? I'm curious.

[Captain Robin Phoenix]

Okay, here are my humble thoughts.

According to Starfleet rules Counseling is indeed part of the medical staff. The part about a counselor being a specialized medical officer is therefor correct. Look at is this way, the Medical Department is split into two levels. One is sickbay and the other one is counseling. All Physical problems are taken care of in sickbay and all psychological problems with counseling. A counselor does answer to the CMO normally, but if you're captain decides other wise... Sometimes both levels combine knoledge. For instance during a mind meld with a crewmember and a counselor. The doctor will participate to monitor physical conditions.

Counseling is also acting like ,what Neelix called, a moral-officer. Spotting problems, observing mood changes, coaching and motivating...in short, keeping people smiling. Also the part of Troi comes in, advising the Captain or First Officer if asked for example. This is because a counselor is specialised in observing behaviour, responses and communications...telepathic/empathic or not! He or she can form a fact based advise about how to approach during ship to ship communication for example. As a counselor you need to completely understand emotions and you will have to be able to have an objective mind at "all" times, or at least simm it :-) A counselor has to learn about everything that goes on inside the mind, and there comes the medical part. Ofcourse a counselor also knows about the anatomy of the brain as well, at some times psychological trauma causes physical pain... a headache for instance.

I hope this helped.

[Gwen Hilzarie]

I can tell you why I am reguarded altmost as command staff and not medical.

A. I'm never in sickbay anymore unless sick. My place is on the bridge next to the captain. And when someone requires it in my office for a session.

B. I am the confidant to both the Captian and the First officer.

C. I hold the third highest rank on the ship.

D. Dispite the fact that I am an MD I am discouraged from practicing medicine.
I know that that is related to the OOC fact that we want the newer people to sim medical but still.

[Gabriel]

I can tell you why I am reguarded altmost as command staff and not medical. 

A. I'm never in sickbay anymore unless sick.  My place is on the bridge next to the captain.  And when someone requires it in my office for a session.

B. I am the confidant to both the Captian and the First officer.

C. I hold the third highest rank on the ship.

D. Dispite the fact that I am an MD I am discouraged from practicing medicine.  I know that that is related to the OOC fact that we want the newer people to sim medical but still.

A. I'm never in sickbay anymore unless sick. My place is on the bridge next
to the captain. And when someone requires it in my office for a session.

Very true, not even for a medical check up when ordered to do so.

B. I am the confidant to both the Captian and the First officer.

Me too, and the rest of the crew and civilians onboard.

C. I hold the third highest rank on the ship.

Hmm I hold the second lowest.

D. Dispite the fact that I am an MD I am discouraged from practicing medicine.

To right aswell, she has a terrible bedside manner.


But dispite that I would prefer it if we could work as a team,
as far as I'm concerned there is no rank in medical.

I still love you Gwen, even if it is only one way, I love all of my crew.

[Gwen Hilzarie]

I have no problem with being a team with medical. And if that is the way the fleet wants to organise it I don't have a problem with that. However I do have a problem with being "Under the Command of the CMO" if the CMO is a much lower rank. Especialy in my case when my Character has a medical degree as well. In that case I think the "CMO" should be the highest ranking MD on the ship weather or not his/her primary duties are medical or counceling.

[T'Lara]

True, true.

I can tell you, based on RL experience, that MD's and Counselors often work hand-in-hand. Since the counselor is not an MD, they are unable to prescribe medications to help their patients recover from whatever mental malady they are manifesting. However, an MD (with the exception of a Psychiatrist, perhaps) might not have the skills to do behavior therapy or talk therapy or what have you. MD's can also refer paitents to a Psychiastrist, who can do both, although most Psychiastrists fall into two categories: clinical and medical. The clinical psychiatrist (while also holding an MD) is a doctor who doesn't do much in the way of hospital work, ect, but does a huge bulk of work in counseling paitents (think "Fraiser"). Medical psychiatrists concentrate on the medical aspects of mental illness, prescirptions, ect.

So, in essence, there can be many steps in the treatment of mental illness. While my RL counselor is great at counseling, he can't diagnose me as having clinical depression. An MD must make that assesment. What his job is to do is to help me deal with my life issues that are contributing to my depression. My MD can diagnose me with depression and suggest a course of medical treatment, such as putting me on an anti-depressant, or what have you. If my depression is not being "fixed" by her chemical solution, she will refer me to a clinical psychiatrist who can work with me to find the appropriate drugs.

I hope this helps ...

Edited by T'Lara, 14 January 2004 - 11:39 AM.

[Captain Robin Phoenix]

It does, and I also agree with Gwen...

The CMO doesn't have to be a "doctor" (counselors are actually also doctors), that is if counseling and medical are one department.